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Food allergy—From food avoidance to active treatment
Author(s) -
Costa Célia,
Coimbra Alice,
Vítor Artur,
Aguiar Rita,
Ferreira Ana Luísa,
TodoBom Ana
Publication year - 2020
Publication title -
scandinavian journal of immunology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.934
H-Index - 88
eISSN - 1365-3083
pISSN - 0300-9475
DOI - 10.1111/sji.12824
Subject(s) - omalizumab , anaphylaxis , medicine , food allergy , allergy , adverse effect , sensitization , immunoglobulin e , adjuvant , immunology , oral food challenge , allergen , immunotherapy , intensive care medicine , antibody , immune system
The prevalence of food allergy (FA) has increased too rapidly, possibly due to environmental factors. The guidelines recommend strict allergen avoidance, but FA is still the main cause of anaphylaxis in all age groups. Immunotherapy is the only treatment able to change the course of allergic disease, and oral immunotherapy (OIT) is the more effective route in FA. However, it carries the risk of adverse reactions, including anaphylaxis. To improve OIT safety, adjuvant therapy with the immunoglobulin E (IgE) monoclonal antibody omalizumab has been extensively used. Results suggest particular benefit in patients with high risk of fatal anaphylaxis. An alternative approach is to use omalizumab instead of OIT to prevent severe allergic reactions upon accidental exposure. This paper reviews current evidence regarding IgE‐mediated FA, focusing on natural tolerance and food sensitization acquisition, and on avoidance measures and their limitations.